“Decades ago, the term ‘cancer’ was typically seen as tantamount to a dramatically shortened life expectancy and potentially even death, due to the lack of developments in contemporary medicine. A prime example of this would be breast cancer; Breast Cancer Ireland states that annually, it results in around 3,700 diagnoses and 690 fatalities, making it the most frequent cancer detected among women in Ireland.
In the developed world, the likelihood of preventable death from breast cancer is greatly high. However, survival rates from the disease in sub-Saharan Africa, particularly Malawi, are dismally low, with a mere 9.5% of patients living past 18 months after being diagnosed.
Such an incongruity propelled the initiation of Akazi, a project planned by the Institute of Global Surgery at the Royal College of Surgeons in Ireland (RCSI). The objective of the project was to enhance survival probabilities for women diagnosed with breast cancer in Malawi. Additionally, Akazi aimed to establish a guide for disease control by introducing the country’s first National Breast Cancer Programme (NBCP).
Dr Jakub Gajewski from RCSI, the principal investigator of the project, expressed great pride in the Akazi team’s accomplishments, following the completion of the project in January. He believes the project not only led to breast cancer gaining priority in Malawi’s national policy but also made a positive impact on the most underprivileged communities, offering newfound hope to several women affected by the disease.
Healthcare worker from Malawi, Maureen Mtanthiko, who was diagnosed with breast cancer at the age of 46 is among the women who have found this hope. She described her initial disbelief in the diagnosis as she didn’t have a familial history of the disease. Eventually, Mtanthiko, now 53, accepted her diagnosis thanks to the collective support from doctors, nurses, friends, and her family, who reassured her of the authenticity of her test results and provided comfort about her forthcoming treatment.”
She explains that her battle with cancer was fraught with challenges due to the scarcity of medications and inadequate resources. As part of her treatment plan, she underwent a mastectomy which had a profound impact on her identity as a woman. “I felt incomplete,” she says, “unjustly less of a woman since society only saw me with one breast.”
Separated by the vast expanse of the ocean, another woman enduring a similar battle is Avril Tierney, a 46-year-old residing in Laois, coping with stage four triple negative breast cancer.
Professor Leonie Young, scientific director of the Beaumont RCSI Cancer Centre, presents that there are two additional primary kinds of breast cancer – HER2-positive and ER+. “There’s a third category encompassing most of the rest,” says the researcher. “Referred to as triple negatives, this group is further sorted into many subcategories. While they can react positively to conventional chemotherapy, they are undoubtedly the most complex to handle.”
“For those dealing with ER+ breast cancer, their circumstances can significantly improve with their life expectancy often closely matching the average. The five-year survival rates for HER2-positive and triple-negative are also fairly high, provided the disease is detected early. The real challenge, however, arises when it relapses – something that happens in roughly 40% of patients – the prognosis then drastically alters,” she explains.
Tierney’s personal journey began in 2019 when a hard lump on her right breast led to a breast cancer diagnosis. Six weeks post-diagnosis, she initiated her treatment that encompassed chemotherapy, a lumpectomy to extract the lump, and radiation for the remaining tissue. Following this, she was prescribed a six-month oral chemotherapy course. “Everything was expected to be fine after that,” she says. Unfortunately, it took an unexpected turn. A 2020 scan revealed nodules in her lung, indicating the disease had advanced to the upper portion of her lung.
Upon diagnosis, doctors were initially hopeful that the top portion of my lung could be surgically removed and the issue resolved with chemotherapy extending over six months. However, despite expectations that my treatment would conclude and I could resume normal life, subsequent scans revealed the growth of two additional tumours now located in the mid-section of my lung. The disease had reached a point where it was manageable but irreversible, thus advancing my condition to stage four.
This mother of two is now committed to lifelong chemotherapy and immunotherapy treatments delivered biweekly at Tallaght University Hospital.
She firmly believes that it’s essential for women to understand that a diagnosis such as hers doesn’t signify the end of life as they know it.
There is presently an eye-opening photographic exhibit, the Akazi Exhibition – Breast Cancer in Malawi, being showcased at Dún Laoghaire LexIcon (Level 4) until the 15th of March. The exhibit highlights the photography of Antonio Jaén Osuna, who has been capturing the authentic experiences of women in rural Malawi, one of the world’s poorest countries, as they combat breast cancer.
For any further details pertaining to breast cancer including its signs and symptoms, do visit breastcancerireland.com.